16 August 2004


Nothing philosophically significant here.* Just another way in which Botox --one of the most potent poisons around-- is useful for more than just destroying the expressiveness of people in LA's faces.

Abstract: Botulinum toxin type A (BoNT-A) shows significant promise in the management of a variety of headache types including migraine, chronic daily headache, tension-type headache, and other head and neck pains. Confirmation of efficacy still awaits the report of well-controlled double-blind placebo-controlled trials; however, a mounting body of evidence suggests that BoNT-A is effective, well-tolerated and safe for the management of many headache disorders. In this paper, I review recent evidence on the efficacy of BoNT-A, and also report my personal experience with the treatment in over 600 headache patients.

Author: B. Todd Troost

DOI: 10.1007/s10194-004-0063-z

Seriously though, since the etiologies of many headaches are so mysterious, any widely effective management technique will lessen a lot of suffering (N.b., people with some headache disorders --e.g., cluster-headaches-- are particularly prone to suicide).

* Okay, one small philosophical note. Its worth thinking hard about why headaches are often so much worse than many sharp and acute pains (e.g., a badly stubbed toe). Two hints:

(1) It is very difficult to disassociate from a mildly severe headache since we usually experience ourselves as being 'in our heads'.** It is comparatively easy to disassociate from a badly stubbed toe or a hammer-smashed finger.

(2) At a fairly low level of intensity, headaches can have a huge negative impact on our lives and well-being. A migraine makes it hard to carry on a civil conversation and can (temporarily) destroy one's capacity for the pursuit of long-term projects and close personal relations.(This becomes more interesting when one believes, as I do, that such effects on one's life can be intrinsic properties of a pain)

**Pace Aristotle, who seems to have believed that the heart is the seat of the soul and (so I've been told) experience.

No comments: